ABSTRACT
Objective: This study aims to evaluate the impact of pharmacist-led medication management clinics in improving medication knowledge among chronic kidney disease (CKD) patients. Methods: This was a retrospective study using a convenient sampling method. All CKD patients age 18 y above with complete pre and post knowledge assessment record were included. The pre-knowledge assessment was done at baseline while the post-assessment was done after a few sessions of medication knowledge teaching done by the clinical pharmacist using medication knowledge assessment form. Demographics data and pre-post knowledge scores were retrieved from patient’s electronic medical record system. All data were analysed using the Statistical Package for Social Sciences (SPSS) version 24. Results: The study shows a total of 13 patients, with the majority being Malay, male with a median age of 60. 84.6% of the patients were consuming more than 5 medications. While 53.9% of patients fall into CKD stage 4 and 5. Patient’s knowledge towards medications improved significantly with an increase in the median pre-knowledge score of 13 to post knowledge score of 18 (p<0.05) after completion of the session. Conclusion: From this preliminary evaluation, pharmacist-led medication management clinic resulted in significant improvement of medication knowledge which is further expected to improve medication adherence and delay the disease progression
ABSTRACT
Objective: To compare the performance of Cockcroft-Gault and Modification of Diet in Renal Disease (MDRD) equations in estimating kidney function in CKD patients with diabetes and hypertension. Methods: This study retrospectively reviewed medical records in Hospital Kajang. The GFR was calculated using Cockcroft-Gault and MDRD equations. Kappa Measure of Agreement was used to check the consistency of CKD staging. Wilcoxon signed-ranked tests and Bland-Altman plots were used to determine the difference of both equations. Spearman correlation was used to determine the correlation between blood pressure and blood sugar levels with eGFR. Results: Data pertaining to a total of 81 patients were extracted. Results showed 22% of the patients were staged differently (Kappa value = 0.644 [P<0.001]) and the majority of them moved down one CKD stage when MDRD equation was used instead of Cockcroft-Gault equation. Wilcoxon signed rank test demonstrated there was a significant difference (P<0.001) in eGFR using CandG and MDRD in patients with diabetes and hypertension. Furthermore, the mean difference observed was 3.78±5.56 [P<0.001]), where the Cockcroft-Gault equation measured 3.78 units higher than MDRD equation. However, the relationship between blood sugar and blood pressure with eGFR were not significant. Conclusion: There was a significant difference between Cockcroft-Gault and MDRD equations in estimating kidney function CKD patients with diabetes and hypertension.